Infertility is a disease that affects the reproductive organs of both men and women. It impairs one of the body’s most basic functions—the ability to have children. Infertility affects about 6.1 million women and men in the United States alone—10 percent of the reproductive-age population.

If you wait to consider your fertility until you’re ready for a family, you may be too late. Just because you aren’t ready for children now, doesn’t mean you should hurt your chances of ever having them. Behaviors you engage in even years before you are ready to have children can impact your future ability to conceive.

Infertility is a disease of men and women’s reproductive organs that impairs one of the body’s most basic functions—the ability to have children. And although 6.1 million people (10 percent of the reproductive-age population) in the United States are infertile, unlike lung cancer or HIV/AIDS, people are rarely informed of the very direct links between their behavior and their reproductive health. Read below to learn how you can help prevent infertility in the future by examining your behavior now.

Smoking can seriously affect your ability have children. Research shows that smoking is harmful to a women’s ovaries, and the degree of damage is dependent upon the amount and length of time a woman smokes. Nicotine and other harmful chemicals in cigarettes interfere with the body’s ability to create estrogen, a hormone that regulates ovulation, and cause women’s eggs to be more prone to genetic abnormalities. While some damage is irreversible, stopping smoking now can prevent further damage.

For more information about smoking, visit the American Lung Association’s website at www.lungusa.org.

Weight

Twelve percent of all infertility cases are a result of a woman either weighing too little or too much. The main ingredient in the body weight and fertility mix estrogen—a sex hormone produced in fat cells. If a woman has too much body fat, the body produces too much estrogen and begins to react as if it is on birth control, limiting her odds of getting pregnant. A woman with too little body fat can’t produce enough estrogen and her reproductive cycle begins to shut down. Both under and overweight women have irregular cycles in which ovulation does not occur or is inadequate.

For more information about nutrition, visit the American Dietetic Association’s website at www.eatright.org.

Sexually Transmitted Infections

Everyone knows that if you don’t practice safe sex, you might get pregnant. However, most people don’t know that if you aren’t using condoms now and you become infected with a sexually transmitted infection (STI), you may never get pregnant in the future. STIs, transmitted form person to person through intimate sexual contact, infect one in three sexually active people by age 24. Common STIs include chlamydia, gonorrhea, syphilis, HIV, genital wars, herpes simplex virus (genital herpes), hepatitis C & B, trichomoniasis, scabies, and pubic lice. STIs are a leading cause of infertility because they often display few, if any visible symptoms. Because women and men are frequently unaware that they have an STI, they fail to seek proper treatment and this threatens their fertility.

For more information about STIs, visit the Center for Disease Control’s website section on STI prevention at www.cdc.org.

Age

It is a biological fact that fertility decreases with age. The decreased odds of getting pregnant are due to normal changes that occur with aging. Women are born with a limited number of eggs. Since no new ones are formed throughout a woman’s life, the number of eggs steadily declines over time. As women age the quality of their eggs declines as well. This doesn’t mean that you should run out and get pregnant, or resolve to never have kids. But you should understand the facts. Bottom line: every woman’s body ages at a different rate and there is no way of knowing for sure what your fertility will be like, say 10 years from now.

Infertility is not just a disease that affects women—men suffer as well. In fact, new studies show that in approximately 40 percent of infertility couples the male partner is either the sole cause or a contributing cause of infertility.

For more information about substance abuse, visit the National Clearinghouse for Alcohol and Drug Information’s website at www.health.org.

Avoid Sexually Transmitted Infections

STIs don’t just affect a women’s fertility. If you become inflicted with an STI, you may never be able to have kids. STIs such as chlamydia and gonorrhea are a leading cause of infertility, often have no symptoms, and can be prevented by regular use of condoms.

If you want to improve your chances of having a baby in the future, practice safe sex now.

For more information about STIs, visit the Center for Disease Control’s website section on STI prevention at www.cdc.org.

Avoid Exposure to High Temperatures

Exposure to high heat, such as that of a hot tub, can affect your fertility by lowering sperm production due to excess heat in the scrotal area. In addition, men whose occupations require long hours of sitting or who wear tight underclothes may also experience decreased sperm production for this reason. When considering your future fertility, it is important to consider the impact of prolonged exposure to heat. To protect your fertility, protect yourself from high-heat situations.

Consider Your Reproductive Plans

Aging doesn’t just affect women’s fertility; it can also affect men. The ability to conceive decreases with aging, affecting sperm shape and motility. While there is no maximum age at which men are not capable of conceiving a child, aging does have an effect. To improve your chances of conceiving, consider your age an important factor.

Protect Your Fertility and Visit Your Doctor

Fertility is something that you should start thinking about as early as possible. Begin a dialogue about this with your doctor early, and ask for more information on the risks out there to your fertility.

Listen to your body. If you’ve been exposed to an STI, see your doctor immediately.

This year’s PSA campaign has generated significant controversy. Several malls and movie theaters in Boston, Houston, San Francisco, and Washington, DC rejected the ads. That’s right, the same malls that house Victoria’s Secret and theaters that show movies full of sex and violence rejected a public service campaign on infertility prevention, claiming that the announcements (PSAs) were not family friendly or entertaining. Similar PSAs were displayed as part of last year’s campaign inside buses in New York, suburban Chicago, and Seattle.

Fortunately, this year’s campaign will appear in other venues. Packets that include a poster and multiple copies of a magazine style newsletter are being distributed to college health centers, community health centers, Planned Parenthood health centers, and YWCA gyms to coincide with National Infertility Awareness Week (September 21-29).

For more information about this year’s campaign, read our launch press release.

View the rejected movie PSAs.

View the rejected mall PSA.

View PSAs from 2001 that were displayed inside buses in New York, suburban Chicago, and Seattle (Adobe Acrobat format).

Much of the information provided on this site is available in a magazine-style publication. The publication is being distributed at select college and Planned Parenthood health centers and YWCA gyms.

The purpose of this website is to expose you to the importance of proactively addressing infertility. While infertility is a disease, it is in many cases a preventable one. The only way to protect your fertility is to understand the facts. Use this site as a starting point and talk to your doctor for more information. The following resources also may be helpful.

Infertility is a disease of the reproductive system that impairs one of the body’s most basic functions: the conception of children. Conception is a complicated process that depends upon many factors: on the production of healthy sperm by the man and healthy eggs by the woman, unblocked fallopian tubes that allow the sperm to reach the egg, the sperm’s ability to fertilize the egg when they meet, the ability of the fertilized egg (embryo) to become implanted in the woman’s uterus, and sufficient embryo quality. Finally, for the pregnancy to continue to full term, the embryo must be healthy and the woman’s hormonal environment adequate for its development. When just one of these factors is impaired, infertility can result.

What Causes Infertility?

In rough terms, about one-third of infertility cases can be attributed to male factors, and about one-third to female factors. For the remaining one-third of infertile couples, infertility is caused by a combination of problems in both partners or, in about 20 percent of cases, is unexplained.

The most common male infertility factors include azospermia (no sperm cells are produced) and oligospermia (few sperm cells are produced). Sometimes, sperm cells are malformed or they die before they can reach the egg. In rare cases, a genetic disease such as cystic fibrosis or a chromosomal abnormality causes infertility in men.

The most common female infertility factor is an ovulation disorder. Other causes of female infertility include blocked fallopian tubes, which can occur when a woman has had pelvic inflammatory disease or endometriosis (a sometimes painful condition causing adhesions and cysts). Congenital anomalies (birth defects) involving the structure of the uterus and uterine fibroids can be associated with repeated miscarriages.

How is Infertility Diagnosed?

Couples are generally advised to seek medical help if they are unable to achieve pregnancy after a year of unprotected intercourse. The doctor will ask many questions and conduct a physical examination of both partners to determine their general state of health and to evaluate physical disorders that may be causing infertility. Usually both partners are interviewed about their sexual habits in order to determine whether intercourse is taking place properly for conception. If no cause can be determined at this point, more specific tests may be recommended. For women, these include an analysis of ovulation, x-ray of the fallopian tubes and uterus, and perhaps a laparoscopy. For men, the initial test is a semen analysis.

How is Infertility Treated?

Eighty five to 90 percent of infertility cases are addressed through conventional therapies, such as drug treatment or surgical repair of reproductive organs. A recent government survey reported that only five percent of infertility cases was treated with in vitro fertilization. However, there’s no guarantee that the woman will become pregnant and most importantly, carry the child to term. While infertility treatments have helped many couples have children, success rates differ depending on the type of treatment.

Do Insurance Plans Cover Infertility Treatment?

The degree of services covered depends on where you live and the type of insurance plan you have. Fourteen states currently have laws that require insurers to either cover or offer to cover some form of infertility diagnosis and treatment. Those states are Arkansas, California, Connecticut, Hawaii, Illinois, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, Texas, and West Virginia. While state laws vary greatly in their scope of coverage, the average couple going through infertility treatments pays at least half of their expenses out of pocket. The costs for these procedures and medications vary widely. On the low end, fertility drugs such as hormone therapy (used to induce ovulation or sperm development) run from $200 – $300 a month. In vitro fertilization, on the other hand (in which the egg is fertilized outside the woman) costs $8,000 to $13,000 per treatment. For more information about state laws, refer to the State Infertility Insurance Laws page of the ASRM website.

ASRM believes the desire to have children and be parents is one of the most fundamental aspects of being human. People should not be denied insurance coverage for medically appropriate treatment to fulfill this goal.

What impact does infertility have on psychological well-being?

Infertility often creates one of the most distressing life crises a couple has faced. The long-term inability to conceive a child can evoke significant feelings of loss. Coping with the multitude of medical decisions and the uncertainties that infertility brings can create great emotional upheaval for most couples. Many couples experience anxiety, depression, and feelings of being out of control or isolated.

A condition in which no semen is expelled from the penis during sexual arousal

Anorexia Nervosa

An eating disorder associated with a distorted body image that is caused by a mental disorder. Inadequate calorie intake results in severe weight loss.

Assisted Reproductive Techniques (ART)

Procedures in which pregnancy is attempted through gamete manipulation outside of the body, such as in vitro fertilization (IVF) or gamete intrafallopian transfer (GIFT)

Azospermia

A cause of male infertility in which no sperm are present in the semen.

Biological Father

The man whose sperm fertilized the ovum from which a child developed and who is therefore genetically related to that child.

Biological Mother

The woman from whose ovum a child developed and who is therefore genetically related to that child.

Bulimia

Bulimia is an illness characterized by uncontrolled episodes of overeating usually followed by self-induced vomiting.

Cervix

The lower, narrow end, or neck, of the uterus, which opens into the vagina.

Chlamydia

A sexually transmitted infection caused by the microorganism chlamydia trachomatis, which if left untreated in a woman may cause pelvic inflammatory disease (PID), pelvic adhesions, and tubal blockage.

Cryopreservation

A special freezing technique used to preserve embryos and sperm for future use in an ART procedure.

Cryptorchidism

A cause of male infertility in which one or both testes have not descended into the scrotum after the first year of life.

Dilatation and Curettage (D&C)

A procedure in which the cervix is gradually widened and the lining of the uterus is gently removed by scraping or suction.

Disease

A disease is defined as any deviation from or interruption of the normal structure or function of any part, organ, or system, or combination thereof, of the body that is manifested by a characteristic set of symptoms or signs. Dorland’s Medical Dictionary 1988: 481.

Dyspareunia

A condition in women in which intercourse is uncomfortable or painful due to a medical problem or emotional issues.

Ectopic Pregnancy

A pregnancy in which the fertilized ovum has implanted in a location other than inside the uterus, usually in a fallopian tube.

Embryo

The fertilized ovum after it has begun the process of cell division.

Endometriosis

A condition in which tissue resembling the lining of the inside of a woman’s uterus is found elsewhere in the body (usually in the pelvis).

Endometrium

The tissue lining the inside of a woman’s uterus, in which a fertilized egg implants at conception.

Epididymis

A structure that covers part of each testis and is the storage place for mature sperm cells.

Estrogen (Estradiol)

A hormone that is produced in a woman’s ovaries and plays a role in regulating ovulation and endometrial development.

Fallopian Tubes

The two narrow, hollow structures located on either side of a woman’s uterus in the lower abdomen, extending to an ovary on each side.

Fetus

In medical terms, an embryo becomes a fetus at about the end of the seventh week of pregnancy, after major structures (head, torso, limbs, etc.) have formed.

Follicle

A structure within the ovary containing the egg that is extruded at ovulation.

Gamete intrafallopian transfer (GIFT)

A variation of ART in which unfertilized eggs and sperm are placed together in the woman’s fallopian tubes, with fertilization taking place in the tube instead of a laboratory dish.

Germ cells (Gametes)

The sex cells—oocytes (eggs) and spermatozoa.

Gestational

Mother In a surrogacy arrangement, the woman who carries a pregnancy to term and delivers a baby, which may or may not be genetically related to her.

Gonorrhea

A sexually transmitted infection caused by the microorganism Neisseria gonorrhea, which if left untreated in a woman may cause pelvic inflammatory disease (PID), pelvic adhesions, and tubal blockage.

Hypothalamus

A structure located at the base of the brain that secretes hormones that regulate the pituitary gland which in turn regulates various bodily functions, including ovulation in women and sperm production in men.

Implantation Bleeding

Light bleeding or spotting that sometimes occurs when a fertilized egg (embryo) implants in the uterus.

Impotence

A condition in which a man cannot achieve or sustain an erection long enough to ejaculate inside a woman’s vagina.

In vitro fertilization (IVF)

A form of assisted reproduction in which an egg and sperm are combined in a laboratory dish and the resulting embryo (sometimes called a preembryo) is subsequently transferred into a woman’s fallopian tube.

Incompetent Cervix

A condition in which a pregnant woman’s cervix begins to dilate too soon, causing miscarriage.

Infertility

The absence of conception after at least one year of regular unprotected intercourse.

Intracytoplasmic sperm injection (ICSI)

A technique in which a single sperm cell is injected through a microsurgical needle directly into the cytoplasm of an egg to facilitate fertilization.

Intrauterine insemination (IUI)

A technique in which sperm are introduced directly into a woman’s cervix or uterus to produce pregnancy, with or without ovarian stimulation to produce multiple ova.

Luteal Phase

The second half of the menstrual cycle, beginning at ovulation (day 14 in an average 28-day cycle) and ending with menstruation

Miscarriage

Spontaneous loss of a pregnancy before twenty weeks of gestation.

Motility

In a semen analysis, the degree to which sperm cells are able to spontaneously propel themselves.

Oligospermia

A cause of male infertility in which fewer than forty million sperm are present in the semen from one ejaculation.

Oocyte

An ovum; the egg before it is released at ovulation.

Ova

The female sex cells, or eggs, which are produced in the ovaries.

Ovaries

Two small organs on either side of a woman’s lower pelvis which produce ova, or eggs, and hormones.

Ovulation Induction

A procedure in which medication is used to stimulate a woman’s ovaries to produce multiple mature follicles and ova.

Pelvic Inflammatory Disease (PID)

Inflammation of the female upper reproductive tract (uterus, tubes, and ovaries) usually resulting from infection with chlamydia and/or gonorrhea.

Penis

The male reproductive organ, through which semen exits during ejaculation.

Perinatologist

An obstetrician/gynecologist specializing in the care of pregnant women and their babies during pregnancy.

Pituitary

A gland located at the base of the brain that is stimluated by hormones released from the hypothalamus to secrete hormones that regulate various bodily functions, including ovulation in women and sperm production in men.

Placenta

The thick pad of tissue inside a pregnant woman’s uterus that provides nourishment to and disposes of waste from the growing fetus.

Polycystic ovarian syndrome (PCOS)

A condition in which an excess number of multiple small cysts form on both ovaries. Women with this condition don’t ovulate on a regular basis.

Postcoital Test

A test used to evaluate the interaction between a man’s sperm and a woman’s cervical mucus.

Premature ejaculation

A condition in which ejaculation occurs before the penis enters a woman’s vagina.

Premature ovarian failure

A condition in which a woman’s ovaries stop producing estrogen and cease ovulation before the age of 40.

Primary Infertility

Infertility in a woman who has never had a pregnancy.

Progesterone

A hormone that is produced in a woman’s ovaries and that stimulates the endometrium to thicken in preparation for possible pregnancy during the latter part of the menstrual cycle (luteal phase).

Prostate Gland

A gland that is located just below a man’s bladder and secretes fluid that helps sperm pass through the urethra.

Reproductive Endocrinologist

An obstetrician/gynecologist who specializes in diagnosing and treating infertility.

Scrotum

A saclike pouch containing the testes at the base of the penis.

Secondary Infertility

Infertility in a woman who has had one or more pregnancies.

Seminal vesicle

A small gland that is located just behind the bladder in the male and stores sperm prior to ejaculation.

Sexually transmitted infection (STI)

An infection that is spread by sexual contact. Also called a sexually transmitted disease (STD).

Sperm cells

The male sex cells (spermatozoa), which are produced in the testes.

Sperm count

An assessment of the number of sperm present in each milliliter of semen.

Sperm penetration assay

A test examining the ability of sperm to penetrate and fertilize a modified hamster egg.

Sperm washing

A procedure used to remove components other than sperm from a semen sample prior to being used for intrauterine insemination.

Testes

Two small organs that are located at the base of the male’s penis and in which sperm are produced.

Testosterone

A hormone that is produced by a man’s testes and helps to maintain the production of sperm.

Thyroid

A gland located at the base of the neck, which secretes hormones influencing metabolism.

Tubal Ligation

A type of female sterilization in which the fallopian tubes are cut, clipped, or tied in order to prevent pregnancy.

Ultrasound

A procedure in which sound waves are used to create an image of the internal structures and organs.

Unexplained Infertility

Infertility for which the cause cannot be determined with currently available diagnostic techniques.

Urethra

A narrow, tube like structure through which urine passes on its way from the bladder to the outside of the body in both sexes. In males, it is also a passageway for sperm.

Uterine fibroids

Abnormal, benign (noncancerous) growths of muscle within the wall of a woman’s uterus.

Uterine polyps

Abnormal, benign (noncancerous) growths attached to a short stalk that protrudes from the inner surface of a woman’s uterus.

Uterus

The hollow, muscular organ in a woman’s lower abdomen, in which a developing fetus grows during pregnancy.

Vagina

The elastic, muscular passageway leading from the cervix to the outside of a woman’s body.

Varicele

A cause of male infertility in which varicose veins are present in the blood vessels above the testes.

Vas deferens

The long, narrow tube through which sperm pass on their way from the testes to the seminal vesicles.

Vasectomy

A procedure for male sterilization, in which a small segment of each vas deferens is surgically removed to prevent sperm from entering the ejaculate.

Zona pellucida

The outer protein coat (shell) of an ovum, which must be penetrated by a sperm cell for fertilization to take place.